Individual
KELLY WHITE RAINWATER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
510 E STONER AVE, SHREVEPORT, LA 71101-4243
(318) 221-8411
Mailing address
4423 CRESWELL AVE, SHREVEPORT, LA 71106-1631
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16746
LA
Other
Enumeration date
02/17/2010
Last updated
07/17/2023
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